You've long since reached tolerence for Xanax, it essentially has lost all efficacy for you. Your doctor should have known better than to keep you on if for four YEARS. Four MONTHS is considered the max treatment time with Xanax. I would speak with my doctor about switching to a long term benzo like Klonopin. It is every bit as potent as Xanax but does not carry all the problems. And since your doctor doesn't know much about benzos, make damn sure he/she understands that you cannot just quit Xanax cold turkey and start another med. You must taper VERY slowly. Even tho the dose you are on is low, you've been on it a very long time. A "cross-over" type switch would be best, in my opinion. You step down slowly from the Xanax and replace it with an equal dose of another medication until you are on the new med only. This takes time and I don't mean just a few days. It COULD take you a few months to make the switch without any breakthrough anxiety/panic.
As someone who knows the horror of Xanax, I highly recommend you seek another medication. But know that ALL benzos come with a price.........and I don't mean the cost of the pill.
I wish you luck.
I was switched to Klonopin years ago. I have dealt with this since I was 16 (I am 34 now). I ended up addicted to Xanax. My doctor explained the Xanax is like a cigarette, it enters the system and burns off quickly, like nicotine. Then you crave more. It was horrible. The switch has done me good. It takes longer for the Klonopin to get out of your system. I didn't notice a difference. You may want to talk to your doctor about an antidepressant to base line support you also. If you can control the symptoms without a band aid solution (such as the Xanax or Klonopin) its worth it. You may still need one or the other for extreme panic. Meditation is also a good way to help manage the anxiety. I can't do the "clear your mind and think of nothing" version, but there is also a free thought version of meditation that allows the thoughts to come and go through your mind, but you don't "attach" to the thought, just let it pass.
Communication with your medical professional is key!
Blessed are the cracked for they let in the light!
The Otter One (Alyssa)